| NPI | 1386376697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OH 30.026887) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA DDS111251) |
| Enumeration Date | 2022-06-27 |
| Last Update Date | 2025-12-08 |